COVID-19: Post-exposure prophylaxis with ivermectin in contacts. At Homes, Places of Work, Nursing Homes, Prisons, and Others

Post-Exposure Prophylaxis (PEP) is aimed at preventing the development of infection and disease after exposure to an infectious agent. PEP is indicated by the WHO, PAHO, the United States HHS and other widely recognized organizations for HIV infection, as well as for other infectious diseases such as Hepatitis B and C, Tuberculosis and Scabies. In the case of COVID-19, PEP is indicated for Contacts of people with a diagnosis of SARS CoV-2 infection. The identification of the Contacts of the infected person is carried out mainly in his or her Place of Residence and Work. If applicable, it is also carried out in School, modes of Transportation as well as other places where the infected may have stayed. PEP is also recommended in the case of Contact with persons suspected of having COVID-19. The Place of Residence may be a place where many people live, such as Nursing Homes, Prisons, Long-Term Residential Centers, Hospitals, among others. In these places, it is often justifiable to carry out large-scale PEP, especially if there are several people already sick on site. Based on local experience and existing publications, a general PEP Scheme consisting of a dose of 0.2 mg per kilo of weight for 2 days is proposed. A third dose (3 days) is indicated in male Contacts between the ages of 45 and 70. And 4 doses is given for men older than 70, and in the person(s) who assume(n) the role of "Caregiver". The inclusion of Acetylsalicylic Acid (ASA) or Aspirin in the PEP Scheme is recommended in for men over 45 years of age and in "Persons with Increased Risk" of developing severe illness. Recommended dose is 1 tablet of 100 mg after lunch for 6 to 10 days. Contacts should remain under observation in case they begin to show characteristic symptoms of COVID-19, in which case they should move to therapeutic doses of Ivermectin. Special care must be taken in elderly people who are bedridden or with reduced mobility, in whom health checks must be more frequent and comprehensive.